Role of Triticum aestivum aqueous extract in glucocorticoid induced osteoporosis in rats.

Administration of aqueous extract of T. aestivum (200 and 400 mg/kg/day, po, for 30 days) and risedronate (20 mg/kg, sc, five times a week for 30 days) following methyl prednisolone sodium succinate (10 mg/kg, sc, thrice a week for 4 weeks) induced osteoporosis in Wistar rats showed an increase in the serum levels of bone mineral content markers, decrease in the serum and urinary levels of bone resorption markers. An incline in strength of femur and tibia was seen particularly with 400 mg/kg of T. aestivum. Maintenance of calcium homeostasis, formation of collagen and scavenging of free radicals can plausibly be the mode of action of aqueous extract of T. aestivum thereby combating osteoporosis induced by glucocorticoids.

[Effects of risedronate on bone turnover markers in osteoporotic postmenopausal women: comparison of two protocols of treatment]

Bisphosphonates are powerful agents able to prevent bone loss. The objective of the study was to evaluate the efficacy and tolerability of risedronate once a week [35 mg] compared with risedronate 5 mg once daily in women with osteoporosis. A randomized, double-blind, active controlled study enrolled 102 postmenopausal women aged 66.5+7.5 years with osteoporotic fractures. All women received risedronate during 6 months. Group 1 [G1, n=51] received risedronate 5 mg once daily and group 2 [G2, n=51] received 35 mg once a week. Serum alkaline phosphatase [ALP], bone alkaline phosphatase [bone ALP], serum C-terminal telopeptide of type I collagen [CTX] were measured at baseline, 3 months and 6 months after treatment in the two groups. We noted no significant difference in markers between women of the 2 groups. After 3 months, bone ALP and CTX decreased [respectively -22.1% and -47.6%] in the 2 groups with no significant difference between them. After 6 months study, bone ALP and CTX decreased respectively by -46.5% and -62.9% with no statistically significant difference between study groups for bone markers. Our study found that treatment with once weekly risedronate 35 mg is able to decrease CTX and bone ALP compared with risedronate 5 mg once daily, in postmenopausal women with osteoporotic fractures. We didn't find adverse events with the 35 mg once a-week dose group compared to the once-daily dose group. Based on these results, the effects of risedronate 35 mg once a week are similar in efficacy to daily dosing and may lead less adverse events than once-a month dose. This therapeutic protocol may provide an alternative for patients who prefer once a week oral dosing

Monitoring of Risedronate by biochemical bone markers in clinical practice.

The study of trend of Risedronate 10 mg/day in menopausal women with a high level of resorptive bone marker (Betacrosslaps, CTx) by the following bone markers:Bone alkaline phosphatase (formation marker) total alkaline phosphatase (TAlP), NMID osteocalcin, undercarboxylated osteocalcin (UcOC) and procollagen type 1 carboxyl propeptides (PICP). Risedronate does not suppress bone resorption deeply that enhances the bone recovers quickly after withdrawal. The level of undercarboxylated osteocalcin was increased after one year of treatment; it may be a sign of vitamin K2 deficiency. The bone alkaline phosphatase was decreased at the end of 12 months and Procollagen type 1 carboxyl propeptides (PICP) of twelfth month changed significantly compared to the sixth months of treatment (p=0.001) The once week 70 mg/week group also changed of CTx the same as daily dose group.

Efficacy of Oral Etidronate for Skeletal Diseases in Japan

Etidronate is an oral bisphosphonate compound that is known to reduce bone resorption through the inhibition of osteoclastic activity. The efficacy of etidronate for involutional (postmenopausal and senile) and glucocorticoid-induced osteoporosis, as well as that for other skeletal diseases, was reviewed in Japanese patients. Cyclical etidronate treatment (200 mg or 400mg/day for 2 weeks about every 3 months) increases the lumbar bone mineral density (BMD) in patients with involutional osteoporosis and prevents incident vertebral fractures in patients with glucocorticoid-induced osteoporosis. The losses of the lumbar BMD in patients with liver cirrhosis and the metacarpal BMD in hemiplegic patients after stroke are prevented, and the lumbar BMD is possibly increased, preventing fragile fractures in adult patients with osteogenesis imperfecta type I. Furthermore, proximal bone resorption around the femoral stem is reduced and some complications may be prevented in patients who undergo cementless total hip arthroplasty. Oral etidronate treatment may also help to transiently relieve metastatic cancer bone pain followed by a decrease in abnormally raised bone resorption in patients with painful bone metastases from primary cancer sites, such as the lung, breast and prostate. Thus, oral etidronate treatment is suggested to be efficacious for osteoporosis, as well as other skeletal diseases associated with increased bone resorption, in Japanese patients. Randomized controlled trials needed to be conducted on a large number of patients to confirm these effects.